AccountId: 011433970860
ContactId: d25dd3dd-282c-45b2-8bfb-166f0a346c12
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 190229 ms
Total Talk Time (AGENT): 92413 ms
Total Talk Time (CUSTOMER): 55976 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/d25dd3dd-282c-45b2-8bfb-166f0a346c12_20250117T16:02_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Good morning. I am calling to verify uh if a patient has mental health benefits.
[AGENT][POSITIVE] OK, sure. I can assist you with benefits, and may I have your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And Miss [PII], may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and may I have the patient's policy number?
[CUSTOMER][NEUTRAL] It is 02463171.
[AGENT][NEUTRAL] Thank you. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] His name is [PII], [PII].
[AGENT][NEUTRAL] Thank you. And what type of service is being rendered?
[CUSTOMER][NEUTRAL] Yeah, he was, um, here, um, this is an inpatient um mental health hospital.
[AGENT][NEUTRAL] OK, um.
[AGENT][NEUTRAL] OK, parameters a sec.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And this was for a sickness?
[CUSTOMER][NEUTRAL] Mental sickness.
[AGENT][NEUTRAL] Mhm, yeah.
[AGENT][NEUTRAL] All right. Yeah, just making sure that it's not due to any addiction. Um, let's see. OK, before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage, and that's just a disclaimer. And Miss [PII], this particular policy is a secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Uh, this one does have an inpatient, um, and the inpatient is 5000 per covered person per calendar year, and this is for sickness or injury.
[CUSTOMER][NEUTRAL] So you cover up to 5000 if it's approved, is that correct?
[AGENT][POSITIVE] Correct. Correct. to be approved by the major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, one second, I'm not taking it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] And may I have your name please?
[AGENT][NEUTRAL] Sure. My name is [PII]'s [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And is that the call reference number as well?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's state if you will.
[CUSTOMER][POSITIVE] OK, alright, thank you so much. I hope you have a good day.
[AGENT][POSITIVE] You're welcome. You as well. Is there anything else I can help you with today, Ms. [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, so do we submit the claims to you or would the patient have to?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The provider can submit the claim, yes, mhm.
[CUSTOMER][POSITIVE] OK all right thank you have a good day.
[AGENT][POSITIVE] You as well, Miss [PII] and thank you for calling APO mhm bye bye.
[CUSTOMER][NEUTRAL] Mhm bye.